The radiological appearances after the endoscopic crico-pharyngeal myotomy: Dohlman's procedure

The treatment of pharyngeal pouches (Zenker's Diverticulum) may be by either open surgical or endoscopic techniques. The endoscopic Dohlman's procedure is an ideal technique in the elderly. However, confusion has been created by the persisting presence of the pouch on the postoperative barium examination, creating the impression of surgical failure. We describe the subtle radiographic findings of the postoperative barium swallow by comparing pre- and postoperative examinations which may be used to indicate the success of the procedure. These include demonstration of the reduced height of the partition wall, the ease of passage of the barium down the ooesophagus and the height of barium supported in the substance of the residual pouch.